Why Talk Therapy Cannot Heal PTSD

The majority of survivors begin PTSD recovery in traditional talk therapy. It’s a natural place to start. As a society we’re very in tune with ‘therapy’ and the idea of talking to a professional when something is wrong emotionally and we don’t know how to fix it.

The Two Sides Of Your Brain

Your brain is divided into two parts: the conscious and subconscious minds. The conscious mind equals 12% of your brain. (That’s right, the place you spend the most time – all of your waking hours – is the smaller part of your brain!) Your subconscious mind equals 88% of your brain. The conscious mind is responsible for short-term memory, logical and analytical thinking and decision making. The subconscious mind holds your long-term memory, your belief system (which drives 100% of your behavior) and is the seat of your associations and perceptions.

The problem is that your conscious and subconscious minds process information differently. You can think of it as if the conscious mind speaks English and the subconscious mind speaks…. any other language! While your conscious mind uses the language you speak to understand and make sense, the subconscious mind uses stories, metaphors and symbols. The two do not communicate effectively, which is why you can sit in talk therapy for years and not find the freedom you desire – you’re only working in the 12% that understands what you’re discussing.

This is also why you can intellectually tell yourself, “It’s ok, I’m safe now,” and still break out in a cold sweat, get a dry mouth and feel your heart pounding – because your subconscious mind is still operating in survival mode. You can talk for years (in fact, for example, I did for eight years on and off) and not reach freedom because you have yet to address the largest part of your brain and the place where it records trauma in the most deep manner.

As a matter of fact, the sole job of your subconscious mind is to keep you safe. Encoded in millions of neural pathways is all the information gathered through your senses from the experiences in your life. In the midst of all of this, the subconscious mind has a little hiccup: It doesn’t understand the difference between the past, present and future. It only understands and processes in the present moment.

When the subconscious mind records a major, dangerous threat that resulted in your potential physical or emotional harm – and then doesn’t receive the message that the danger has passed; you are safe – it can become stuck in survival mode. In this process the subconscious mind perceives the present moment (even as safe as it may be) as dangerous and becomes over reactive in its quest to keep you safe, unnecessarily responding to all kinds of innocuous stimuli. You may feel ‘crazy’, but it’s just your subconscious mind doing what it thinks is best.

What to do about all of this? While choosing your recovery path you need to address both sides of your brain. Ideas for how to reconceive your therapeutic approach in this post about “When Talk Therapy Fails To Heal PTSD”.

Great Blog Michele!
People need to know that talk therapies like CBT have serious limitations when treating PTSD. It simply doesn’t address the unconscious and emotional components of our memory. Oops, sorry. CBT says that the unconscious doesn’t exist because they haven’t found a way to research it! Those of us who treat PTSD and those who have healed know better, don’t we!

@Dr. Dave — I love your sense of humor, and honesty! Thank you for helping me widen the conversation about PTSD recovery so that we cut a path of individuality, recognizing and understanding that everyone is individual and there are many ways to heal — and many reasons to use a variety of options.

This is very insightful. Knowing this could be extremely helpful to many. This underscores the importance of a holistic approach to therapy. While Cognitive-Behavioral Therapy CBT is a researched-supported, “proven” technique that does indeed help people identify faulty thinking patterns and replace them with healthier beliefs, in my professional and personal experience, CBT has limitations. Someone can definitely feel an understanding for CBT on an intellectual level but yet have difficulty internalizing the beliefs on a deeper level. I think you’ve helped illuminate why that is!

@Tanya – Great to have you here! You bring up a good point: We can’t get so married to what has been ‘proven’ as a technique. Clinical research is not the only way to prove the efficacy of other practices. Talking to survivors and practitioners using alternative modalities can often offer equally valid insights.

please i need as much info on this as possible i start another class on monday. me and my seven children have been abused and i want the right treatment for all of us. instead of triggering garbage and misbeliefs

I think the point of talking is so that the qualities of the conscious part of your brain can help to put things in perspective; it teaches the subconscious things like that it wasn’t my fault, despite the guilt (both are true!). Saying ‘It’s ok, I’m safe now’ does NOT make you feel safe when you have PTSD, but saying ‘oh god, I’m dying, I can’t handle this’ makes it worse!

I tried to heal without talking about it for ~ a decade (CBT [visualization/deep breathing/positive thinking/etc], EMDR, EFT, DBT, etc) and I kept having debilitating relapses. Proper medication and Prolonged Exposure Therapy/talk therapy (without numbing out in order to speak) is what is finally helping me recover (at first, though, I was completely unable to speak, because of that 88% thing); it is taking away the power of the flashbacks – they’re more like distressing memories now; it makes me feel brave and strong; I am learning to trust; I know, like REALLY KNOW that I’m safe and will be OK when I’m in a triggered place. This process is taking years, but it is so worth the effort. I can only speak for myself though..

@Nadia – Thanks for sharing your insights and experience. I’m so happy hear that you’ve found a way to move forward. Your input underscores how true it is that our healing is so individual and we absolutely must keep looking for the thing(s) that bring us closer to freedom.

@Rich — I’m so glad the information has been useful to you! I found in my own journey the more I knew the more I was able to find the help that I needed. Have you discovered my radio show yet? Tons of the top trauma professionals offering advice about healing:

Great blog! Too bad I am so late at commenting.
At our agency in Miami, FL we educate the clients about the psychobiology of trauma as part of our treatment . None of our facilitators engage in talk therapy but rather help the clients resolve their traumas by using Traumatic Incident Reduction (TIR), an evidence based technique with data to be very effective.